Osgood Schlatters – A common cause of knee pain in adolescents

Osgood Schlatters is the term given to knee pain in adolescents that is caused by inflammation at the attachment site of the patella tendon onto the tibial tuberosity.

It is one of the few common ‘growing pains’ that we see in kids, especially in those that are more active or who are undergoing a growth spurt.

When a child grows the bones grow quickly and the soft tissues inscluding the muscles and tendons can’t keep up which can cause them to become short and tight. In the case of Osgood Schlatters the quadriceps gets tight. It blends into the patella tendon, so as the quad contracts during running & jumping activities it pulls on its attachment on the tibial tuberosity creating pain and inflammation. This happens in growing kids because their bones are still soft and not as well adapted to withstand the constant tension as adult bones.

What are the symptoms? 

  • Pain at the front of the knee, usually over the tibial tuberosity.
  • Swelling can be present around this area
  • Tenderness to touch of the tibial tuberosity
  • Pain is aggravated by running, jumping & other sports related activities. In an acute episode the pain can also be felt during simple tasks such as climbing stairs.
  • In more severe cases the tibial tubercle may become enlarged and this can stay around into adulthood (you should see Nick’s knees!!!)

What can be done?

Firstly it’s important to understand that Osgood Schlatters is a self limiting condition. What we mean by this is that if your child is suffering from this condition it does not mean they are not allowed to play sport at all. We tend to suggest activity modification especially when they have are suffering from an acute episode of pain. These conditions tend to come in waves depending on the level of activity and whether the child is in the middle of a growth spurt. They may have bad pain one week, and be almost pain free the following week.

During painful episodes re-assessing the amount of training and sport being played is one of the keys to managing your child’s injury. For example instead of 3-4 x training and 2 x games you may need to reduce the training to 1-2 x and only play the more important game. This allows for a significant reduction in load through the knee.

Obviously in severe cases rest from sport all together may be necessary.

Physiotherapy can be helpful in the management of Osgood Schlatters. Some common treatment techniques including;

  • Soft tissue massage of the quadriceps
  • Biomechanical evaluation – some children have contributing factors that may place them at greater risk of suffering from such conditions. For example; pronated (flat) feet, weakness or stiffness of the hip joints. These can be an important consideration for longer term management.
  • Advice regarding footwear, tendon straps and self-management strategies surrounding self-massage and effective stretching. ( Check out this video on our instagram on how to self massage your quadriceps)
  • Icing
  • Anti-inflammatory medication such as neurofen can be useful when pain is severe*

If you have any questions regarding Osgood Schlatters the Active RX door is always open, or feel free to email us at activerxphysio@gmail.com or comment below.

*Always check with your doctor if medication is appropriate, especially if you have not taken neurofen before. Children with asthma should not take neurofen